HomeMy WebLinkAbout3625 Marshall Streeti CITY OF WHEAT RIDGE
Boilding Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type:
Job Address: l�
Permit Number:
XRelonspectionrequired:j/
one available for inspection: Time��AM M
es No
When corrections have been made, call for re -inspection at 303-234-5933
Date: ' 1-7 Inspector:
DO NOT REMOVE THIS NOTICE
City of Wheat Ridge
E -Res. Window Replacement PERMIT - 201802961
PERMIT NO: 201802961 ISSUED: 11/08/2018
JOB ADDRESS: 3625 Marshall St EXPIRES: 11/08/2019
JOB DESCRIPTION: Replacement of 7 windows and 1 door throughout home. Like for like with no
structural changes.
U -value of .27.
*** CONTACTS ***
OWNER (303)506-3602 RAMOS MARIO
SUB (.888)736-6335 Adam Kaliner
160260 Power Home Remodeling Group
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 10,392.19
FEES
Window Replacement 50.00
Total Valuation 0.00
Use Tax 218.24
** TOTAL ** 268.24
*** COMMENTS ***
*** CONDITIONS ***
Windows shall comply with all applicable codes, have a .32 or better U -factor and shall be
safety glazing if within a tub enclosure, less than 18 inches above the floor or within 24
inches of a vertical edge of a door.Both the front and back of this permit are required to
be posted on the job site at all times. If the complete permit is not present, inspections
WILL NOT be performed.
Work shall comply with 2012 IRC & 2017 NEC. Per IRC Sec. R314, smoke detectors are required
to be installed in every sleeping room, in hallways outside of sleeping rooms, and on every
level of the structure.
City of Wheat Ridge
E -Res. Window Replacement PERMIT - 201802961
PERMIT NO: 201802961 ISSUED: 11/08/2018
JOB ADDRESS: 3625 Marshall St EXPIRES: 11/08/2019
JOB DESCRIPTION: Replacement of 7 windows and 1 door throughout home. Like for like with no
structural changes.
U -value of .27.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and specifications,
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am t e legal owner or have been authorized
by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
thispermit. I further attest that I am legally authorized to include all entities named within this document as parties to the work to be
performed and that all work to be performed is disclosed in this document andlor its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
I. This permit was issued based on the information provided in the permit application and accompanying plans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Re uests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and may be subject to a fee equal to one-half of the originalpermrt fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees and procedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Oficial and is not guaranteed.
4. No work of any manner shall be performed that shall results in a changeof the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any provision of any
applic code or anypidinance or regulation of this jurisdiction. Approval of work is subject to field inspection.
Signature of Chief Building Official Date
REQUESTS MUST BE MADE BY 11:59PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
La enia Reimer
From: no-reply@ci.wheatridge.co.us
Sent: Thursday, November 8, 2018 8:50 AM
To: CommDev Permits
Subject: Online Form Submittal: Residential Window/Door Replacement Permit Application-�
Categories: Gina
Residential Window/Door Replacement Permit Application
This application is exclusively for RESIDENTIAL REPLACEMENT WINDOWS and
DOORS - LIKE FOR LIKE ONLY.
YOU MUST ATTACH A VALID CREDIT CARD AUTHORIZATION FORM AND
WINDOW/DOOR CUTSHEET (SPEC SHEET) IN ORDER FOR THE PERMIT TO
BE PROCESSED. Your Permit will be emailed to the email address provided below
once it is processed.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
WORK UNTIL PERMIT HAS BEEN ISSUED. `)
Is this application for Yes
replacement window(s)
and/or door(s) like for
like?
PROPERTY INFORMATION
Property Address
Property Owner Name
Property Owner Phone
Number (enter WITH
dashes, eg 303-123-4567)
Property Owner Email
Address
Attach Credit Card
Authorization Form -
**DO NOT ATTACH
RANDOM
DOCUMENTS**
3625 Marshall Street
Mario Ramos and Idana Espinoza
303-506-3602
shane.laird@powerhrg.com
00. CC Auth for online submit.pdf
CONTRACTOR INFORMATION
Contractor Business Power Home Remodeling
Name
Contractor's License 160260
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone 888-736-6335
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address 2501 Seaport Drive
(Primary address of your
business)
Contractor Email Address shane.laird@powerhrg.com
Retype Contractor Email shane.laird@powerhrg.com
Address
DESCRIPTION OF WORK
Number of window Remove and replace 7 win, 1 door (same size/location). U -
and/or doors being factor 0.27. SHGC 0.25. No structural changes.
replaced
Location of throughout house
window(s)/door(s) being
replaced (for example,
master bedroom, kitchen,
bathroom, etc):
What is the a -value of the 0.27
window(s)/door(s)? City
of Wheat Ridge requires
the u -value to be .32 or
better on windows..
Attach copy of 33-51939 Ramos.pdf
window/door cut sheets
showing sizes and u -value
Project Value (contract 10392.19
value or cost of ALL
materials and labor)
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full Yes
responsibility for
PJ
compliance with
applicable City of Wheat
Ridge codes and
ordinances for work
under any permit
issued based on this
application.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have been Yes
authorized by the legal
owner of the property to
submit this application
and to perform the work
described above.
I attest that everything Yes
stated in this application
is true and correct and
that falsifying
information in this
application is an act of
fraud and may be
punishable by fine,
imprisonment, or both.
Person Applying for Shane Laird, PowerHRG
Permit
Email not displaying correctly? View it in your browser.
National Headquarters Mario Ramos
2501 Seaport Drive, Chester, PA 19013 33-51939
888-736-6335
WWW.POWERHRG.COM
Amended Project Specifications
AMENDED
Windows: TV Room F 1 82.0"x47.0"
WINDOWS: Models SL 2700 Styles Slider Types 3 -Lite Configs 1/4 - 1/2 - 1/4
OPTIONS: ColorAlmond / Almond : Grid Pattern : None I Removal Steel I Additional Details None
AMENDED
Windows: Master Bedroom F 1 50.0"x47.25'
WINDOWS: Models SL 2700 Styles Slider Types 2 -Lite Configs None
OPTIONS: Co/or Almond / Almond : Grid Pattern : None I Removal Steel I Additional Details None
AMENDED
Windows: Master Bedroom L 1 33.75'x47.25'
WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None
OPTIONS: Color Almond / Almond : Grid Pattern : None I Removal Steel I Additional Details None
AMENDED
Windows: Office L 1 33.75'x47.25'
WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None
OPTIONS: Color Almond / Almond : Grid Pattern : None I Removal Steel I Additional Details None
AMENDED
Windows: Office B 1 33.75'x47.25'
WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None
OPTIONS: Color Almond / Almond : Grid Pattern : None i Removal Steel I Additional Details None
AMENDED
Windows: Kitchen B 1 33.5'x35.0"
WINDOWS: Models SL 2700 Styles Slider Types 2 -Lite Configs None
OPTIONS: Color Almond / Almond : Grid Pattern : None I Removal Steel I Additional Details None
November 07, 2018 13:04
National Headquarters
2501 Seaport Drive, Chester, PA 19013
888-736-6335
WWW.POWERHRG.COM
Amended Project Specifications
AMENDED
Windows: Garage R 1 34.0"x35.25"
WINDOWS: Models SL 2700 Styles Slider Types 2 -Lite Configs None
OPTIONS: Color Almond / Almond : Grid Pattern : None I Removal Steel I Additional Details None
November 07, 2018 13:04
Mario Ramos
33-51939
National Headquarters Mario Ramos
2501 Seaport Drive, Chester, PA 19013 33-51939
888-736-6335
WWW.POWERHRG.COM
Amended Project Specifications
AMENDED
Doors: Front Door 1 36.0"x79.0"
DOORS: Models Dynasty Series Styles Entry Door Types Composite Configs Textured Fiberglass Options
Half View: Clear Color 1 -Color : Options : Natural Oak I Hardware Avalon Handleset : Interior
Commonwealth Lever: Deadbolt : Satin Nickel I Additional Details None
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City of Wheat Ridge
` Residential Roofing PERMIT - 201707913
PERMIT NO: 201707913 ISSUED: 10/02/2017
JOB ADDRESS: 3625 Marshall ST EXPIRES: 10/02/2018
JOB DESCRIPTION: Residential Re -roof to install 30yr CertainTeed Landmark Moire Black
asphalt shingles with 18.33sq pitch=5/12
*** CONTACTS ***
OWNER (303)506-3602 RAMOS MARIO
SUB (303)456-4444 Kelly Simon & Scott Zibull 090425 K. Simon Construction
*** PARCEL INFO ***
ZONE CODE: UA / Unassigned USE: UA / Unassigned
SUBDIVISION CODE: 2405 / BARTHS, COULEHAN GRANGE, WHEAT BLOCK/LOT#: 0 /
*** FEE SUMMARY *** ESTIMATED PROJECT VALUATION: 8,426.49
FEES
Total Valuation 0.00
Use Tax 176.96
Permit Fee 188.45
** TOTAL ** 365.41
*** COMMENTS ***
*** CONDITIONS ***
Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be
required for both the midroof and final inspections. The 3rd party inspection report AND
THE ORIGINAL PERMIT CARD needs to be dropped off to the Permit Desk at the City of Wheat
Ridge. The report MUST BE SIGNED by the Homeowner.
REGARDING ROOF VENTILATION: Roof ventilation shall comply with IBC Sec. 1203.2 or IRC Sec.
R806. The installation of ridge venting requires the installation or existence of soffit
venting. For calculation purposes, one hat or turtle vent equal to one-half of one square
foot of opening.
Effective December 1, 2014, asphalt shingle installations require an approved midroof
inspection, conducted when 25-75 percent of the roof covering is installed, prior to final
approval. Installation of roof sheathing (new or overlay) is required on the entire roof
when spaced or board sheathing with ANY gap exceeding one half inch exists. Sheathing and
mid -roofs may be called in at the same time, one hundred percent of the sheathing must be
complete and 25-75 percent of the mid -roof may be complete. Asphalt shingles are required
to be fastened to the roof deck with a minimum of 6 nails per shingle. Ice and water shield
is required. Eave and rake metal is required. A ladder extending 3 feet above the roof eave
and secured in place is required to be provided for all roof inspections. Roof ventilation
is required to comply with applicable codes and/or manufacturer installation instructions,
whichever is more stringent. In order to pass a final inspection of elastomeric or similar
type roof coverings, a letter of inspection and approval from the manufacturer technical
representative stating that "the application of the roof at (project address) has been
applied in accordance with the installation instruction for (roof material brand name) roof
covering" is required to be on site at the time of final inspection.
Midroof & Final Roof inspections for ROOFS 6/12 PITCH & OVER: 3rd party inspection will be
required, the 3rd party inspection report AND THE ORIGINAL PERMIT CARD needs to be dropped
off to the Permit Desk at the City of Wheat Ridge. The report MUST BE SIGNED by the
Homeowner.
PERMIT NO:
JOB ADDRESS:
JOB DESCRIPTION:
City of Wheat Ridge
Residential Roofing PERMIT - 201707913
201707913
3625 Marshall ST
Residential Re -roof to
asphalt shingles with
ISSUED:
EXPIRES:
install 30yr CertainTeed
18.33sq pitch=5/12
10/02/2017
10/02/2018
Landmark Moire Black
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanyingg approved plans and specifications,
applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the legal owner or have been authorized
by the legal owner of the property and am authorized to obtain this permit and perform the work described and approved in conjunction with
thispperm t I further est that I am legally authorized to include all entities named within this document as parties to the work to be
\ er med �d that lywork to be performed is disclosed in this document and/or its' accompanying approved plans and specifications.
Signature of O R or CONTRACTOR (Circle one) Date
I. This permit was issued based on the information provided in thepermit application and accompanying Flans and specifications and is
subject to the compliance with those documents, and all applicable statutes, ordinances, regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must be made in writing and
received prior to the date of expiration. An extension of no more than 180 days made be granted at the discretion of the Chief Building
Official and maybe subject to a fee equal to one-half of the originalpermit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to the standard
requirements, fees androcedures for approval of any new permit. Re -issuance or extension of expired permits is at the sole discretion of
the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy of all required
inspections and shall not proceed or conceal work without written approval of such work from the Building and Inspection Services
Division.
6. The issuance or granting of a permit shall AMW construed to be a permit for, or an approval of, any violation of any provision of any
applicable code or any ordinance or regulatio. f this jurisdiction. Approval of work is subject to field inspection.
Sigiq@1'Ruildl<nDate
REQUESTS MUST BE MADE BY 11:59 Y BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
Lagenia Reimer -7 -7 I ��
From: no-reply@ci.wheatridge.co.us
Sent: Thursday, September 28, 2017 12:01 PM
To: CommDev Permits
Subject: Online Form Submittal: Residential Roofing Permit Application
Categories: Gina
Residential Roofing Permit Application
This application is exclusively for new permits for residential roofs and for licensed
contractors only. This type of permit is ONLY being processed online --do not come
to City Hall to submit an application in person. Permits are processed and issued in
the order they are received and due to the volume of requests, time to process
varies and is subject to change. YOU WILL BE CONTACTED WHEN YOUR
PERMIT IS READY FOR PICK-UP AND WILL BE GIVEN A SPECIFIC DATE
AND TIME WINDOW TO COMPLETE THE TRANSACTION. You will be notified if
your contractor's license or insurance has expired, and you may update those
documents at the time you are issued your permit.
For all other requests:
Homeowners wishing to obtain a roofing permit must apply for the permit in person
at City Hall. Revisions to existing permits (for example, to add redecking) must be
completed in person at City Hall. All other non -roofing permits must be completed in
person at City Hall. The Building Division will be open from 7:30-10:30 a.m.,
Monday through Friday to process these types of requests.
THIS APPLICATION DOES NOT CONSTITUTE A PERMIT. DO NOT BEGIN
REROOFING UNTIL PERMIT HAS BEEN ISSUED.
Is this application for a Yes
residential roof?
How many dwelling units Single Family Home
are on the property?
PROPERTY INFORMATION j
Property Address 3625 Marshall t
Property Owner Name Mario Ramo'
Property Owner Phone 303-506-3602
Number (enter WITH
dashes, eg 303-123-4567)
73
l
Property Owner Email
Field not completed.
Address
Do you have a signed
Yes
contract to reroof this
misty@ksimon.com
property?
Applications cannot be
submitted without an
18.33--'�
executed contract
attached below.
8426.49
Attach Copy of Executed
2017 09 28 12 56 20.pdf
Contract
CONTRACTOR INFORMATION
Contractor Business
K Simon Construction
Name
Is the permit for a flat
Contractor's License 090425
Number (This is a 5 or 6
digit number for the City
of Wheat Ridge)
Contractor Phone 303-456-4444
Number (enter WITH
dashes, eg 303-123-4567)
Contractor Address 1420 Vance St # 202, Lakewood, CO 80214
(Primary address of your
business)
Contractor Email Address
misty@ksimon.com
Retype Contractor Email
misty@ksimon.com
Address
DESCRIPTION OF WORK
TOTAL SQUARES of
18.33--'�
the entire scope of work:
Project Value (contract
8426.49
value or cost of ALL
materials and labor)
Are you re -decking the
No r
roof?
Is the permit for a flat
Pitched roof (2:12 pitch or greater)
roof, pitched roof, or
74
both? (check all that
apply)
What is the specific pitch 5/11
of the PITCHED roof?
How many squares are
part of the PITCHED
roof?
Describe the roofing
materials for the
PITCHED roof:
Type of material for the
PITCHED roof:
Provide any additional
detail here on the
description of work. (Is
this for a house or
garage? Etc)
18 f
30 yr Certainteed Landmark Moire Black
Asphalt
r
none
SIGNATURE OF UNDERSTANDING AND AGREEMENT
I assume full Yes
responsibility for
compliance with
applicable City of Wheat
Ridge codes and
ordinances for work
under any permit
issued based on this
application.
I understand that this Yes
application is NOT a
permit. I understand I will
be contacted by the City
to pay for and pick up the
permit for this property.
I understand that work Yes
may not begin on this
property until a permit
has been issued and
posted on the property.
I certify that I have been Yes
authorized by the legal
75
owner of the property to
submit this application
and to perform the work
described above.
I attest that everything Yes
stated in this application
is true and correct and
that falsifying
information in this
application is an act of
fraud and may be
punishable by fine,
imprisonment, or both.
Name of Applicant Misty Powers
Email not displaying correctly? View it in your browser.
76
WORK ORDER AND AUTHORIZATION
K SIMON CONSTRUCTION 61
OF COLORADO, INC. BBB
T_
1420 Vance Street x202
Lakewood, Colorado 80214
fi*Nationwide
CONSTRUCTION COMMERCIAL and RESIDENTIAL
Office (303)456-4444 GENERAL CONTRACTOR
LICENSED •INSURED
5U3^sITTEo TO
r-1-AILIM13 DDRt55 -_ - - ' ,rSo -j-/�-
o CITY, STATE Yif CODE _
I08 I E U R 55
CITY, STA, E, CODE
K SIMON CONSTRUCTION proposes to furnish material and labor - complete in accordance with specifications below:
/7
For the Total Contract Amount Of:
-- OR --
The TOTAL CONTRACT AMOUNT will be determined accordi g to the INSURANCE ALLOWANCE AGREEMENT below.
Payment to be made as follows: - - � down ',r•i' s�-s :i t-� alance upon completion of work.
SCOPE OF WORK: (only those items indicated with a X' in the left column)
Existing damage/known problems:
❑ 1. Ground Preparation: Tarps ❑ - Other:
Tear off existing z of layers: --i— Type of layers: 11t 51, u, 2"0 _ 3`
[(NOTE• Additional charges will result if additional roof layers are discove d during tear off.)
Inspect roof for dry rot and other damage. Repair damage at a rate of $_C per man hour plus materials;
or S_ �2 per square foot if re-cde/ening is required. (These are additional costs over & above original contract price)
!d 4. stall: underlayment: 15;* felt
L'f • 30z felt ❑ -Other. �7`
5. Install metals: Roof -to -Wall C3- Step Flashing El- Gable'End ❑ - Gutter Edge Valley Metal ❑
(NOTE: Additional charges will result if any siding, stucco, brick or other removal is needed for proper installation
froof ?�asnings, or if gutter2---Ile
,remoovai is required for proper installation of roofing materials.)
Dl -'7
/6. Install: Starter Course 2�tee and Water Shield C3> Location:
D v. Install Area Material: Manufacturer:/T "I,"� Type: Color:
❑
S. Install:
W install metal flashing to: Chimney ❑ - Skylight E7co,unter Flash ❑ - Other:
10. Install vents: AF -SO Vents ❑ - Replace a "CJ - Cut In = Total = _
Install vents: Ridge Vent Q - Total Linear Feet: y
Install plumbing flashings: 1.5"= 2"=3"= J 4"=
Clean Up: Gutters ®!Walkways B`- Driveways E ir_ard/Q
;NOTE: Debris drop box is for roofing materials only. Additional charges will result if used for other disposal,)
�3. K. Simon Construction to provide Sym year workmanship/labor warranty.
Manufacturer providesyear materials warranty (Registration with manufacturer may be required).
❑ OPTIONS:
INSURANCE ALLOWANCE AGR E 14 / INT
IF INITIALED BY CUSTOMER HERE f L/ Customer agrees to the following additional provisions:
A. work performed by Corn ( imon Construction) will be completed at NO COST to Customer other than the insurance
deductiole, unless (1) Customer requests upgrades or additional work that is not approved by Insurer; or (2) Customer's insurance
Policy ones not provide for total replacement cost coverage, In which event Customer agrees to pay for the difference between
total Replacement Cost Value (RCV) and the Actual Cash Value (ACV) of Company's Work as determined by Insurer.
B. Customer authorizes Company to discuss Company's pricing and scope of work for the services described herein at a price
acceptable to Insurer.
C. TOTAL CONTRACT AMOUNT will be the total Replacement Cost Value (RCV) as listed on the final approved
Insurance Scope of Loss (or final approved K Simon Construction Scope of Work) including ail direct costs, labor and
materials, depreciation, customer deductible, taxes, base service charges, overhead and profit; plus any approved insurance
supplements; plus any upgrades, options or additional work performed at the request of the Customer.
D. K Simon Construction is a contractor, and not a licensed public insurance adjuster. Therefo-e, Customer agrees to provide
all necessary documents, information and assistance for timely submission of claims and receipt of payments to/from Insurer and
mortgagee(s) without delay. Company reserves the right to receive additional payments from Insurer due to material or labor
increases due to storm environment, or if insurance claim measurements and/or information provided by Customer or Insurer are
incorrect.
E. Customer hereby assigns all amounts due from insurer for Company's work to Company. Customer appoints Company as
rc/s representative to c/o)lect and receive all insurance payments related to Company's work.
AIL-—
1L__ -S /S9ss/ e/ -sem_ She
INSURAN_ COMPANY D--cDUCrlBLE POLICY o CLAIM s ADIUSTER NAME AND PHDriF s _
itions of this
PRINT SALES REPRESENTATIVE NAME AND PHONE NUMBER
including all terms and conditions on the reverse side:
CUSTOMER SIGNATURE DATE
SALES REPRESENTATIVE SIGNATURE DATE
This Agreement is not effective until approved by company management. THIS AGREEMENT VOID IF NOT ACCEPTED WITHIN 14 DAYS.
AUTHORIZED COMPANY MANAGEMDATE
ENT SIGNATURE TITLE
Certificate Holder
The certificate holder as indicated in the left-hand box at the bottom of the certificate is
issued the document after making a request to either the policyholder or the insurance
broker. Being a certificate holder means that you are given proof that insurance is in effect.
Additionally, as a certificate holder, if the policy is canceled, the insurance company will
attempt to notify you of the policy's cancellation. 4
Additional Insured and Ancillary Coverages
A certificate of insurance can only mirror the coverages and terms as
outlined in the insurance policy. Therefore, if you, as a certificate
holder, want a certificate to list you as an additional insured on a
liabili policy or a loss payee on a property policy, the insurance
policy must be endorsed first. Once the policy is endorsed adding you
or your firm as an additional insured and/or loss payee, then the
certificate of insurance can be modified to list you accordingly- The
policy is modified first, the certificate of insurance second.
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7/31/2017 Approved Third - Party Inspectors
List
Roofs 6/12 pitch or over will require a third party inspection. All other inspections
will be completed by the City of Wheat Ridge. Below, please find the list of approved
third party inspectors. Third party inspectors may be added to the list provided proper
qualifications are submitted to the Building Department for approval prior to any inspections
completed. The cost of the third party inspection is the repsonsibility of the permit holder or
its agent. Inspectors may not inspect properties that may a conflict of interest or have
any personal interest in. "All third party inspections must have the contractor remove
25% of the singles in order to complete a third party inspection."
Scott Martin
SAFEbuilt
970-227-9267
11684 N. Huron Ste 104B
Northglenn, Co 80234
smartina-safebuilt.com
Jim Pepper
James R. Pepper, LLC
719-494-7768
15790 Candle Creek Dr
Monument, CO 80132
aim. pepper2013ca"�gmail.com
JBA Consulting
Gary Manlove
720-443-8280
P.O. Box 283
Larkspur, CO. 80118
gary.man lovea_gmail.corn
Certified Builing
Kraig Stanforth
720-228-1408
Consultants
11177 Chambidge Ct
Parker, CO 80138
kstanforthcbc()_gmail.com
Clearview Design
Josiah Flamm
720-560-7066
4199 Timber Hollow Loop
Castle Rock, CO 80109
clearviewSD@yahoo.com
Burgess Construction
Alan Wittren
303-300-4527
Consultants, Inc.
9033 East Easter PI. Suite 200
Centennial, CO 80112
awrittenaburgess-inc.com
Mae' -Lae'
Donald Hamilton
760-660-9517
12305 View Point DR #B
Lakewood 80401
awritten(abburgess-inc.com
7/31/2017 Approved Third - Party Inspectors
List
Roofs 6/12 pitch or over will require a third party inspection. All other inspections
will be completed by the City of Wheat Ridge. Below, please find the list of approved
third party inspectors. Third party inspectors may be added to the list provided proper
qualifications are submitted to the Building Department for approval prior to any inspections
completed. The cost of the third party inspection is the repsonsibility of the permit holder or
its agent. Inspectors may not inspect properties that may a conflict of interest or have
any personal interest in. **All third party inspections must have the contractor remove
25% of the singles in order to complete a third party inspection."
Scott Martin SAFEbuilt 970-227-9267
11684 N. Huron Ste 104B
Northglenn, Co 80234
smartin(aD_safebuilt.com
Jim Pepper James R. Pepper, LLC 719-494-7768
15790 Candle Creek Dr
Monument, CO 80132
jim.pepper2013(a�gmail.com
JBA Consulting Gary Manlove 720-443-8280
P.O. Box 283
Larkspur, CO. 80118
gary.man love(ab-gmail.com
Certified Builing Kraig Stanforth 720-228-1408
Consultants
11177 Chambidge Ct
Parker, CO 80138
kstanforthcbc(�i)-gmail.com
Clearview Design Josiah Flamm 720-560-7066
4199 Timber Hollow Loop
Castle Rock, CO 80109
clearviewSD@yahoo.com
Burgess Construction Alan Wittren 303-300-4527
Consultants, Inc.
9033 East Easter Pl. Suite 200
Centennial, CO 80112
awritten(&-burgess-inc.com
Mae' -Lae' Donald Hamilton 760-660-9517
12305 View Point DR #B
Lakewood 80401
awritten(a-)-burgess-inc.com
7/31/2017 Approved Third - Party Inspectors
List
Roofs 6/12 pitch or over will require a third party inspection. All other inspections
will be completed by the City of Wheat Ridge. Below, please find the list of approved
third party inspectors. Third party inspectors may be added to the list provided proper
qualifications are submitted to the Building Department for approval prior to any inspections
completed. The cost of the third party inspection is the repsonsibility of the permit holder or
its agent. Inspectors may not inspect properties that may a conflict of interest or have
any personal interest in. **All third party inspections must have the contractor remove
25% of the singles in order to complete a third party inspection.**
Scott Martin SAFEbuilt 970-227-9267
11684 N. Huron Ste 104B
Northglenn, Co 80234
smartin(i_)safebuilt.com
Jim Pepper James R. Pepper, LLC 719-494-7768
15790 Candle Creek Dr
Monument, CO 80132
jim.pepper2013(a-)gmail.com
JBA Consulting Gary Manlove 720-443-8280
P.O. Box 283
Larkspur, CO. 80118
gary.manlove(&gmail.com
Certified Builing Kraig Stanforth 720-228-1408
Consultants 11177 Chambidge Ct
Parker, CO 80138
kstanforthcbc(a)-gmail.com
Clearview Design Josiah Flamm 720-560-7066
4199 Timber Hollow Loop
Castle Rock, CO 80109
clearviewSD@yahoo.com
Burgess Construction Alan Wittren 303-300-4527
Consultants, Inc.
9033 East Easter PI. Suite 200
Centennial, CO 80112
awritten(@_burgess-inc.com
Mae' -Lae' Donald Hamilton 760-660-9517
12305 View Point DR #B
Lakewood 80401
awritten(a)-burgess-inc.com
i CITY OF WHEAT RIDGE
Building Inspection Division
(303) 234-5933 Inspection line
(303) 235-2855 Office • (303) 237-8929 Fax
INSPECTION NOTICE
Inspection Type: 3 C & - f cl
Job Address: 3 L, -;;2c 0"7 mss%, e,
Permit Number: a c► -7 o-., c f 3
❑ No one available for inspection: Time �`� AM(O
Re -Inspection required: Yes No
When corrections have been made, call for re -inspection at 303-234-5933
Date: / c /L % / -7 Inspector: `7'6
DO NOT REMOVE THIS NOTICE
INSPECTION NC
'IC
❑ No one available for inspection: Time/L/
Re-inspect ion required: Yes
When corrections have been made, call for re-inspection at 303-23
Date: ie Inspector: Z
DO NOT REMOVE THIS NOTICE
- r�
City of Wheat Ridge
Faxed Plumb. Permit PERMIT - 110735
PERMIT NO: 110735 ISSUED: 06/27/2011
JOB ADDRESS: 3625 MARSHALL ST EXPIRES: 06/26/2012
DESCRIPTION: Replace 40 gallon hot water heater
* ** CONTACTS * **
owner 303/995 -0955 Michelle Albert
sub 866/898 -0008 Mariana Kitchukova
08 -0021 Colorado Delta Mechanical Inc.
** PARCEL INFO
**
ZONE CODE:
UA
USE:
UA
SUBDIVISION:
0477
BLOCK /LOT #:
0/
** FEE SUMMARY ** ESTIMATED PROJECT VALUATION: 850.00
FEES"
Permit Fee 40.00
Total Valuation .00
Use Tax 15.30 lMV s
** TOTAL ** 55.30 --
Conditions:
Both front and back of permit need to be posted on job site. If one or the other
is not present, INSPECTION WILL NOT BE PERFORMED. Work shall comply with 2006
IRC & 2005 NEC. Per IRC Sec. R313, smoke detectors are required to be installed
in every sleeping room, in hallways outside of sleeping rooms, and on every
level of the structure. Carbon Monoxide detectors are required to be installed
within fifteen(15) feet outside the entrance to each sleeping room. Subject to
field inspection.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and
specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the
legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform
the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all
entities named within this document as parties to the work to be performed and that all work to be performed is disclosed in
this document and /or its' accompanying approved plans and specifications.
Signature of OWNER or CONTRACTOR (Circle one) Date
1. This permit was issued based on the information provided in the permit application and accompanying plans and
specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances,
regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must
be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted
at the discretion of the Chief Building Official and may be subject to a fee equal to one- half of the original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to
the standard requirements, fees and procedures for approval of any new permit. Re- issuance or extension of expired
permits is at the sole discretion of the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior
and specific approval.
5. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy
of all required inspections and shall not proceed or conceal work without written approval of such work from the
Building and Inspection Services Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of
any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject
to field inspect n.
Signature Building Offical Date
INSPEC, ON REQUEST LINE: (303)234 -5933 BUILDING OFFICE: (303)235 -2855
REQUESTS MUST BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
INSPECTION RECORD Occupancy /Tvpe
INSPECTION LINE: (303) 234 -5933
Inspections will not be made unless this card is posted on the building site
Call by 3:00 PM to receive inspection the following business day.
1 IA In Ir �Y a
INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB v
FOUNDATION INSPECTIONS
DATE
INSPECTOR
INITIALS
COMMENTS:
Footings /Caissons
Stemwall / (CEG) Concrete
Encased Ground
Reinforcing or Monolithic
Weatherproof /.French Drain
j tie
Sewer Service Lines
Water Service Lines
ervice
CONCRETE SLAB FLOOR
Electrical (Underground)
Plumbing (Underground)
Heating (Underground)
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
j tie
ervice
Rough Electric
Rough Plumbing
Gas Piping
Rough Mechanical
ABOVE INSPECTIONS TO BE SIGNED PRIOR TO PRO CITY OF WHEAT RIDGE
Framing 06 /27/11 10:43 AN cdba
Insulation Mariana Kitehukav
Drywall Screw RECEIPT NO:CDA006055 AMOUNT
DPSP Replace 40 gallan he 55.30
FINALS 110735
Perant Fee 40.00
Electrical Use Tax 15.30
Plumbing PAYNDIT RECEIVED AMOUNT
Mechanical VS 3376 55.30
Roof Auth Code:
007967
Building Final TOTAL 55.30
Fire Department
R.O.W & Drainage INSPECTIONS FOR PLANNING & ZONING, FIRE AND PUBLIC WORKS SHOULD
Parking & Landscaping BE CALLED AT LEAST ONE WEEK PRIOR TO FINAL INSPECTIONS.
` * NOTE: ALL ITEMS MUST BE COMPLETED AND APPROVED BY PLANNING AND ZONING, BUILDING AND PUBLIC WORKS BEFORE A
CERTIFICATE OF OCCUPANCY IS ISSUED. FINAL INSPECTION BY THE BUILDING DIVISION DOES NOT CONSTITUTE AUTHORIZATION
_ OFA CERTIFICATE OF OCCUPANCY NOR PERMISSION FOR OCCUPANCY.
OCCUPANCY NOT PERMITTED UNTIL CERTIFICATE OF OCCUPANCY IS ISSUED
PROTECT THIS CARD FROM THE WEATHER
♦ 11,1 i
City of
h
W .,�
_r COtU DEVELO ME p rm,t #: `0 35
eullding Dlvlslon
7500 W. 29" Ave., Wheat Ridge, CO 80033
Office: 303 - 235 -2855 * Fax: 303.237.8929
Inspection Line: 303. 234.5933
Property Address: JI
Property Owner (please
Facsimile Building Permit Application
303 -9q5- (x155
Use of s ace (description):
Day ion of work: n
added:
Plen Raview (due at time of aubmlttal): $ I
Gallons
OWNERICONTRACTOR SIGNATURE OF UNDER8TANOINO AND AOREEMENT
applicable ordinances,
I hereby ceriiry that the setback diatancas proposed by this permit application are accurate, and do not vimafa
rules or rogulailons of the Clty of Wheat Ridge or covenants, easements or roatrictlons of record; that all measurements shown, and
allegations made are accurst ®; that I have read and aggree to abide by all conditions printed on this applicatlan and that I assume full
respo nsibllkt for compliance with the Wheat Rld ®e Bulldln0 Code (LB,C) and all other applicable Wheat Ordinances, for work
under this permit. Plane subject to field Inspection.
CIRLCEONE: OW`NE,R,) �(- C- O�NTRACT R) or PERSONAL R PR S NTATIV of 0 ER) CO TRATO ' n '
PRINT NAME: tJ(�l 81ONATUR Date: �i( 1i
ZONING COMMENTS:
zoning:
Reviewer.
PUBLIC WORK& COMMENTS!
Reviewer,
DEPARTMENT USE ONLY
WILDING DEPARTMENT COMMENTS;
Reviewer.
FIRE DEPARTMENT:; O approved w/ comments ❑ disapproved ❑ no reNew required I Bldg Valuatlon:
Credit Card Payment: Use credit card listed on file. Date:
Print name: Signature:
UE '�J (896' °N ]AHS WN90 :6 llOZ U unr
Sub Contractors:
Oomoanv Name: License #: Expiration Date: Trade /Profession: Approval:
41 City of Wheat Ridge
1 r 9r
Residential Roofing PERMIT - 110684
PERMIT NO: 110684 ISSUED: 06/15/2011
JOB ADDRESS: 3625 MARSHALL ST EXPIRES: 06/14/2012
DESCRIPTION: Reroof 14 sqs with 30 yr Tamkoshingles, 3sgs modified
* ** CONTACTS * **
owner 303/995 -0955 Michelle Albert
sub 303/466 -0161 Bernie Reitz 01 -9543 Reitz Roofing, Inc.
** PARCEL INFO **
ZONE CODE: UA
SUBDIVISION: 0477
USE: UA
BLOCK /LOT #: 0/
** FEE SUMMARY ** ESTIMATED PROJECT VALUATION: 4,500.00
FEES
Permit Fee 125.05
Total Valuation .00
Use Tax 81.00
** TOTAL ** 206.05
Conditions:
6 nails per shingle is required. Ice dam membrane is required from eave edge to
2' inside exterior walls. Board sheathing with any gap greater than 1/2"
requires panel sheathing overlay on entire roof. Sheathing inspection is
required prior to covering. Contractor shall provide ladder for inspections.
Scheduled inspections that cannot be performed due to inclement weather must be
cancelled prior to 8:30 a.m. on the day of inspection or a re- inspection fee
will be assessed. Subject to field inspection.
I, by my signature, do hereby attest that the work to be performed shall comply with all accompanying approved plans and
specifications, applicable building codes, and all applicable municipal codes, policies and procedures, and that I am the
legal owner or have been authorized by the legal owner of the property and am authorized to obtain this permit and perform
the work described and approved in conjunction with this permit. I further attest that I am legally authorized to include all
entities named w'thin thi document as parties to the work to be performed and that all work to be performed is disclosed in
this docum
en d /or accompanying approved plans and specification .
b�l�Jl!
Signature of OWNER or CONTRACTOR (Circle one) - Date
1. This permit was issued based on the information provided in the permit application and accompanying plans and
specifications and is subject to the compliance with those documents, and all applicable statutes, ordinances,
regulations, policies and procedures.
2. This permit shall expire 365 days after the date of issuance regardless of activity. Requests for extension must
be made in writing and received prior to the date of expiration. An extension of no more than 180 days made be granted
at the discretion of the Chief Building Official and may be subject to a fee equal to one- half of the original permit fee.
3. If this permit expires, a new permit may be required to be obtained. Issuance of a new permit shall be subject to
the standard requirements, fees and procedures for approval of any new permit. Re- issuance or extension of expired
permits is at the sole discretion of the Chief Building Official and is not guaranteed.
4. No work of any manner shall be performed that shall results in a change of the natural flow of water without prior
and specific approval.
S. The permit holder shall notify the Building and Inspection Services Division in accordance with established policy
of all required inspections and shall not proceed or conceal work without written approval of such work from the
Building and Inspection Services Division.
6. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of
any provision of any applicable code or any ordinance or regulation of this jurisdiction. Approval of work is subject
to field inspection.
Signat £.Building Offical Date
EQUEST LINE: (303)234 -5933 BUILDING OFFICE: (303)235 -2855
BE MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION THE FOLLOWING BUSINESS DAY.
COMMUNITY DEVELOPMENT DEPARTMENT Building Permit Number:
of WHE BUILDING INSPECTION LINE - 303 - 234 -5933
Date:
° CITY OF WHEAT RIDGE
o m 7500 WEST 29TH AVENUE
WHEAT RIDGE, CO 80033.(303-235-2855)
c O�ORA0 0
APPLICATION
Property Owner: In.- C A.'11 r '4 /be.. ?
Property Address: y`j y„ s�, !/ S)( Phone: --
Contractor License No.:
Company:' R4,i fZ Rr' T / ^9 C.
Pho
✓ ! s V
OWNERICONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certify that the setback distances proposed by this permit application are
accurate, and do not violate applicable ordinances, rules or regulations of the City of
Wheat Ridge or covenants, easements or restrictions of record; that all measurements
shown, and allegations made are accurate; that I have read and agree to abide byall
conditions printed on this applicat and that I assume full responsibility for
compliance with the Wheat Ridge Building Code (Ly$,C) and all other applicable
Wheat Ridge Ordinances, for yDFI - n4pr this perm' .
— /O•(/
Value:$ 9 1--nv e,
Permit Fee:$
Plan Review Fee:$
Use Tax
Total:$
tvvMtrc)kwN I RAOTOR):PRINTED
Description: / /o / /' e'7 rN
Sq. Ft. added / y - 3 ®
BUILDING DEPARTMENT USE ONLY SIC: Sq.Ft.:
F oning: MMENTS: MENTS: roval:
roval•
PUBLIC WORKS COMMENTS:
Approval:
Occupancy: Walls: Roof: Stories: Residential Units:
Electrical License No: Plumbing License No: Mechanical License No:
Company: Company: Company:
Expiration Date: Expiration Date: Expiration Date:
Approval: Approval: Appro
(1) This permit was issued in accordance with the provisions set forth in your application and is subject to the laws of the State of
Colorado and to the Zoning Regulations and Building Codes of Wheat Ridge, Colorado or any other applicable ordinances of
the City.
(2) This permit shall expire if (A) the work authorized is not commenced within sixty (60) days from issue date or (B) the building
authorized is suspended or abandoned for a period of 120 days.
(3) If this permit expires, a new permit may be acquired for fee of one -half the amount normally required, provided no changes
have been or will be made in the original plans and specifications and any suspension or abandonment has not exceeded one
(1) year. If changes have been or if suspension or abandonment exceeds one (1) year, full fees shall be paid for anew permit.
(4) No work of any manner shall be done that will change the natural flow of water causing a drainage problem.
(5) Contractor shall notify the Building Inspector twenty-four (241 hours in advance for all inspections and shall receive written
approval on inspection card before proceeding with sucecggssive phases of the job.
(6) The issuance of a permit or the approval of drawings and specifications shall not be construed to be a permit for, nor an
approval of, any Violation of the provisions of the building codes or any other ordinance, law, rule or regulation.
Chief Building Official
. . . . c ° :
4' CITY OF WHEAT RIDGE i
Building Inspection Division I
(303) 234-59331nspection line ~
. (303) 235-2855 Oflice ' (303) 235-2857 Fax ~
INSPECTION NOTICE
Inspection Type:
Job Address/Permit Numbec
,//k: O
❑ No one available for insqecfow., Time AM/PM
Re-Inspection required: Yes !
, "When correction9 have 6een mad4, call r re-inspection at 303-234-5933
Date: " > >i , . ~l 1,~1 {r _ Inspector:
DO NOT REMOVE / NOTICE
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City of Wheat Ridge
/ Residential Electric PERMIT - 080782
PERMIT NO: 080782 ISSUED: 07/14/200.8
JOB ADDRESS: 3625 MARSHALL ST EXPIRES: 01/10/2009
DESCRIPTION: 200 AMP upgrade install 4 GFIs
CONTACTS
owner 303/525-7203 Mir_helle Albert
gc 303/424-9733 John Basil 01-8765 Basil Electric
PARCEL INFO
ZONE CODE: UA
SUBDIVISION: 0477
USE: UA
BLOCK/LOT#: 0/
FEE SUMMARY ESTIMATED PROSECT VALUATION: 1,500.00
FEES
Permit Fee 70.25
Total Valuation .00 DM
Use Tax 27.00
TOTAL 97.25
Conditions:
Must comply w/ 2003 IRC & 2005 NEC.
I hereby cer[ify that [he setback di_s[ances proposed 5y this pennit appL:cation are accurate, and do not violate applicable
ordinances, rules or regulations of the City of Wheat aidge or coveaants, easements or restric[ions of rewrd; that all
measurements shown, and~allegations made a ccurate; ihat I have read and agree to abide by all conditions printed on Chis
application and that I assume full respo i lity for compliance with the Wheat RiJge Building Code (I.H.C) and all otber
a_p `plicable Wheat RidavlJrdin ce , fior under this permit. Plans subject to field inspection.
• '1 ♦
Signature of contracCOrjownes e~~ I da[e
1. This permi[ was issued in accordance with the prwisions set Eorth in your application and is svbject to the laws of [he
State of Colorado and to the Zon-ing Regulations and 2vildir:g Codes of wheat Ridge, Colorado or any other applicable
ordinancee of the City.
2. This permit shall expire 180 days from the issue date. eequeses foz an extension mus[ be received prior [o expiration
date. An extension may be granted at ehe discretion of the Builcing OEEicial.
3. If this permit expirea, a new per.miL may be acquired for a fee of one-halE the amount normally required, provided r.o
changes have been oz wi11 be mada i~ the original plans and specifications antl any suspension or abandonment has not
exceeded one (1) year. If changes kLave been or if suspension or abandonment exceeds one (li year, full fees shall
be paid for a new permit. -
4. No work of any manner shall' be done Uiat will change the natural flow of water causing a drainage problem.
5. Contractor shall notify the Building Inspector twenty-four (24) hours in advance for all inspections and shall receive
written approval on inspection card before proceeding with successive pnases of the job.
6. The issuance of a permit or the app~wa1 of drawings and specifiw[ions sha11 not be construed to be a permit for, nor
an approval of, any violation of the provisions of the building codes or any other ordinance, law, rule or regulation.
All plan review is subject Ao.field inspections.
Signature of ChieE Bui fficial dace INSPECTION REQ ST LINE: (303)234-5933 BUILDING OFFICE: (303)235-2855
REQUESTS MUST E MADE BY 3PM ANY BUSINESS DAY FOR INSPECTION TFiE FOLLOWING BUSINESS DAY.
; F W"~T City of Wheat Ridge Building Division Date:
~ 7500 W. 29th Ave., Wheat Ridge, CO 80033
Offce: 303-235-2855 * Fax: 303-235-2857 Plen
` Inspection Line: 303-234-5933 g,~~~~
°cona Permif Q
Q
Building Permit Application
Property Addrws: .j (p S I (
Property Owner (please print):ly~~ Phone: 303-51;L 5 -
Mailing Address: (if different than property address)
Address:
State,
Conhactor:
~ I e- c~~ i C_
~Pj G
i
Contractor License
/ x' 7(n ~
Phone: 30
3-q-xy-cl 733
Sub Contractom:
Etectrical City License Plumbing City License Mechanical City License
Company: Company Company:
Exp. Date: Exp. Date: Exp. Date:
Approval: Approval: Approval:
Use of space (description): Constructfon Value: S 1500
DescNption of work: ~ p T 5Q~ U k (y, ~ (as celculated per the Bullding ValuaNon Data sheet)
,~00 AM~1✓~St~ UFT ir\ joGA1-,fGt7rvt, Plan Review (due at Hme ofsubmittaq: 5
lnS~ 'J C'7~.Ls rn k-itc.P~.ti-
Sq. Ft./L.Ft added: Squares BTU's Gallons Amps
OWNER/CONTRACTOR SIGNATURE OF UNDERSTANDING AND AGREEMENT
I hereby certiry that the setback distances proposed by this pertnit application are accurate, and do not violate applicable ortlinances,
rules or regulations of the Cky ot Wheat Ridge or covenants, easements or restrictions of recrord; that all measuremenGS shown, and
allegations made are accurate; that I have reatl and agree to abide by all condilions printed on this application and that I assume full
responsibilily for compliance with the Wheat Ridge Building Code (I.B.C) and all other appliceble Wheat Ridge Ordinances, for work
under this peimit. Plans Subject to field inspectlon.
GRLCEONE:: (OWNER) (CONTRACTOR) or PERSONALREPRESENTATI (O ) (CONTRATOR)
PRINT NAME:1• ~alq0.rp~ SI 1 Date: 1`} l78
20NING COMMENTS:
Zoning:
Reviewer
PUBLIC VYVRK3 COMMENTS:
Raviewer.
DEPARTMENT USE ONLY
BUILDINCa DEPARIIMENT COMMENTS: OCCUPANCY:
Reviewer.
FIRE DEPARTTfENT:: O Bpprovetl w/ comrlleMS ❑ dlsepprovetl ❑ n0 rovfew roqUlrod